I am a Professor of Medicine at the University of California San Francisco (UCSF). I am a pulmonary and critical care medicine specialist with a clinical and translational research focus in HIV-associated pulmonary diseases, and I am committed to training the next generation of researchers in this field. For this K24 renewal, my career goals and research objectives are to: (1) continue to provide comprehensive mentoring and research support to T32/F32 fellows and K Assistant Professors on research and career development and focused mentoring to other junior investigators on specific research projects. A special emphasis will be assisting my K mentees to make the challenging transition to full independence (e.g., R01 award); (2) expand my Distance Mentoring and Mentoring the Mentor experience; (3) join a new UCSF initiative and assist under-represented minority and women faculty obtain their own K24 awards; (4) continue my research focus on HIV-associated opportunistic pneumonias, the lung microbiome, and chronic obstructive pulmonary disease (COPD) and expand my current research to study the lung microbiome that persists after pneumonia and declines in lung function and development COPD. Our central hypothesis is that post-pneumonia changes in the lung microbiome are associated with declines in lung function and the development of COPD in HIV- infected persons. Aim 1: To compare the composition of the lung microbiome at baseline and 3-months and 1- year after acute pneumonia treatment using a standardized phylogenetic microarray (PhyloChip). Aim 2: To compare the structure of the lung microbiome at baseline and 3-months and 1-year after acute pneumonia treatment using high-throughput DNA sequencing (Illumina MiSeq). Aim 3: To correlate the lung microbiome composition and structure with changes in lung function and development of COPD in this cohort. To address these aims, we will conduct a longitudinal study of 25 HIV-infected Pneumocystis pneumonia (PCP) subjects and 25 HIV-infected TB subjects, and we will perform research bronchoscopy at 3-months and 1-year after the completion of pneumonia treatment. We will compare the lung microbiome in these individuals at the time of pneumonia to the lung microbiome after the completion of treatment using PhyloChip and MiSeq and will correlate microbiome composition and structure with lung function and chest computed tomography measurements.